Benefits Administrator Customer Service
Resume:
Kevin R. Kreis
Schenectady, NY 12302
Email: ********@*****.***
EDUCATION
****-************ ** *******, **** Institute of Technology at Utica/Rome
****-***8Associate of Applied Science, Mohawk Valley Community College
LICENSE(S)
2018 New York State Property and Casualty Insurance Agent/Broker License
2017 New York State Life, Accident, and Health Insurance Agent/Broker License
EMPLOYMENT HISTORY
Benefits Account Manager
Leading Edge Administrators 2022-Present
Oversee all policy activity aspects of assigned accounts including, but not limited to implementation, member issues, delinquencies, stop-loss policy coverage status, enrollment maintenance and others. Engage appropriate resources as needed for assistance.
Manage self-funded employee benefits administration; assisting current and new clients with questions, claims and billing issues to a successful resolution.
Execute the pre-renewal and renewal process. Assess and determine client needs to determine the best benefit options.
Organize and present client meetings to include employee enrollment meetings.
Lead the process for plan enrollment including employee communication, case submission, plan implementation and follow through on all processes.
Serve as a resource to clients for current market condition and ongoing benefit regulation changes, industry information and underwriting.
Learn and become an effective user of benefit administration technology to best assist clients, create and run reports, interact with operations, optimal record keeping and client management. Use all technology available to run reports for regular client presentation.
Participate in industry events and other training to maintain knowledge and skill development.
Actively seek referrals from current client base for new business prospects.
Develop strong working relationships with the broker and key contacts for assigned accounts.
Interact with contacts at various vendors that support the accounts benefits administration.
Approve client plan documents (SBC’s, SPD Summaries, etc.) and employee ID Cards prior to generation.
Track and review employer claims for appropriateness and payment. Approve high dollar claims for payment.
Account Manager-Employee Benefits
Benetech, Inc. 2021-2022
Manage existing accounts.
Provide courteous and prompt customer service to clients as assigned and requested.
Handle all aspects of benefits management (enrollment, eligibility, claims resolutions, communications, compliance, and insurance renewals).
Maintain activities system to follow up on outstanding tasks, correspondence, reports, and follow up on overdue and suspense items (tracked in CRM).
Develop an excellent knowledge of all partner carrier and vendor websites and their functions.
Perform projects at management’s request.
Maintain a positive, empathetic and professional attitude toward clients and team members.
Benefits Coordinator-Catskill Area Schools Employee Benefit Plan
Otsego Northern Catskills BOCES 2013 – 2021
Responsibility for coordination of a self-funded consortium offering health and welfare, dental, vision, worker's compensation, and flexible benefit plans. Meeting with client school district Administrators to present cost-saving benefit options for both their union and non-union membership, provide guidance to clients to resolve coverage or client issues, and to work with our consultants to develop value-added options for our client school districts. Contacting employees, retirees, and insurance carriers for the purpose of ensuring effective program operation and resolving individual problems. Promotes health insurance programs, reviews enrollment applications, and provides technical assistance to enrollees regarding benefits. Responsibility for program administration with subcontractors, representatives of insurance companies, and the ONC BOCES to develop and update procedures for enrolling employees. Supervision over the work of administrative staff.
Special Achievements:
oSpearheaded effort to write new Point of Service (POS) and High Deductible Health Plans for the Catskill Area Schools Employee Benefit Plan (CASEBP) in order to contain medical costs.
oCollaborated in search for ways to increase savings with our Pharmacy Benefit Manager, joined the Keenan Pharmacy Purchasing Coalition in 2013 that has so far saved CASEBP over five million dollars.
oOrganized and implemented flu shot clinics for the 21 school districts in CASEBP the past six years to further our mission of providing wellness programs to our component school districts.
oLaunched and implemented an Employer Group Waiver Plan (EGWP) for our Medicare primary retirees that has saved the CASEBP over $5,000,000 since 2016.
Human Resources-Benefits Administrator, NYS Insurance Fund 2012-2013
Benefits Administrator for NYS Insurance Fund employees throughout NYS. Provide guidance to new and existing union and non-union employees regarding their benefits which include Medical, Dental, Vision, M/C Life Insurance plans, Long-Term Care Insurance, Deferred Compensation, Flexible Spending plans, Family Medical Leave Act (FMLA), Disability, and Worker’s Compensation. Make determinations regarding eligibility of employees and dependents for benefits and make changes to enrollment files as necessary. Conduct background investigations of prospective employees, new-hire orientation, and employee training regarding their current benefits and their benefits when they retire.
Senior Adjunct Instructor, Department of Medical Studies, Mildred Elley 2011-2013
I was a professor in the Department of Medical Studies teaching Medical Insurance and Medical Office Management. This includes giving practical instruction in HIPAA Privacy Rules and Practices, medical information and record management, common insurance carriers, government programs, legal issues, medical insurance claims coding and filing, claims processing, appointment scheduling, financial management, and proper medical office written and verbal communications.
Supervisor, Benefit Services, NYS Dept. of Civil Service 2005-2012
Supervisor of a group of representatives providing guidance to client agencies and enrollees in the administration of the New York State Health Insurance Program (NYSHIP) offering health and welfare benefits for both union and non-union employees and retirees. Make final decisions on determining eligibility for benefits.
Expertise in the benefit plans provided by 12+ health insurance carriers, 3+ PBMs, and contracted dental and vision plans; as well as Medicare Advantage.
Handling of more complex written and telephone inquiries referred by subordinates regarding pre-retiree and retiree benefits, FMLA, Workers’ Compensation, union and non-union benefits, waivers of premium, and benefit administration.
Leader and developer of training sessions and seminars throughout NYS for NYS employees and retirees regarding their benefits, policies, and procedures of NYSHIP. Small and large group presentations.
Special Achievements:
oSelected to collaborate on production of NYSHIP benefits, policies & procedures training video in cooperation with the NYS Governor’s Office of Employee Relations. Online: Oct. 2010.
oSelected to represent Rx concerns in RFP contract negotiations.
Utilize MSWord, Excel, Access, FileNet and NYBEAS, NYSTEP, and PayServ (PeopleSoft) dual screen technology.
Unemployment Insurance Investigator, NYS Dept. of Labor 2004-2005
Investigated cases of alleged fraud or collusion by claimants or employers, employee misconduct, and complex cases involving self-employing entities and corporations to determine claimant eligibility.
Conducted formal examinations involving sworn testimony of employers, claimants, and witnesses.
Analyzed evidence and issued determinations on behalf of the Commissioner of Labor, including cases referred to the District Attorney for prosecution.
Correction Officer, NYS Dept. of Corrections 1994-2004
Provided supervision, security, and care of inmates both inside and outside a correctional facility.
Senior Medical Claims Examiner, Metropolitan Life Insurance Company 1987-1994
Supervisor of Adjustment and System Team (6 claims examiners) in medical claims examination and payment reconciliation.
Provided guidance to members, other insurance carriers and attorneys regarding medical benefits.
Handled complex cases regarding recovery of overpayments from members or providers, and subrogation recovery cases with worker’s compensation and auto insurance carriers.
Leader of training sessions of employees on new claim payment systems.
Seven years of medical claims processing experience.
Special Achievement: Selected to transfer to New Mexico to service new major account: US West. Promoted to Senior Medical Claims Examiner.
Specialist Four, United States Army 1983-1985
Honorably discharged veteran of the United States Army, stationed in Germany.
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